Abstract: An apparatus having a discharging energy source, two electrodes adapted to make electrical contact with a patient, a connecting mechanism forming an electrical circuit between the energy source and the electrodes and a controller operating the connecting mechanism. The apparatus delivers electrical energy from the energy source to the electrodes having a waveform optimized in the frequency domain to have a dominant frequency in a preset range.

Abstract: A method and apparatus for processing physiological data, particularly non-electrocardiogram, cardiac-related data, by identifying the physiological data associated with atypical cardiac cycles.

Abstract: An envelope based amplitude mapping achieves the signal compression required to provide a natural sound level without the high processor loading or waveform alteration. In a preferred embodiment, the output of a family of parallel bandpass filters is processed by an envelope detector, followed by decimation. The resulting reduced data rate envelope is log mapped to produce a scaling factor for the original high data rate bandpass filter output sequence. The resulting scaled signal determines the current level for stimulation of the cochlea for each frequency band, which stimulation achieves a log mapping of the sound amplitude effect similar to natural hearing, while reducing processor load, and preserving waveform shape.

Abstract: An implantable pump system including an external driver. The implantable pump is driven by the external driver during normal operation but may also operate on a battery. The external driver is used to drive the pump with the mechanical energy of the impeller also being used to charge the battery. The external driver is also useful during emergency situations to directly drive the pump if the battery or internal coils should fail. The pump is also preferably implanted in a subpectoral location outside the patient's rib cage.

Abstract: A subcutaneous implantable cardioverter-defibrillator is disclosed which has an electrically active canister which houses a source of electrical energy, a capacitor, and operational circuitry that senses the presence of potentially fatal heart rhythms. At least one subcutaneous electrode that serves as the opposite electrode from the canister is attached to the canister via a lead system Cardioversion-defibrillation energy is delivered when the operational circuitry senses a potentially fatal heart rhythm. There are no transvenous, intracardiac, or epicardial electrodes. A method of subcutaneously implanting the cardioverter-defibrillator is also disclosed as well as a kit for conducting the method.

Abstract: An apparatus for body surface mapping comprises a plurality of electrodes for attachment to spatially separate locations on a human torso with each electrode capable of detecting the electrical activity associated with a heartbeat and producing a corresponding voltage. The electrodes are sampled at a rate of 1 KHz during a cardiac cycle and sets of sampled values are produced and stored. Positional variations of the maximum and minimum sampled values over time are displayed as a projection of trajectories of the maximum and minimum sampled values in a three dimensional (x, y, t) space onto planes perpendicular to a plane containing the electrodes.

Abstract: An elongated coronary vein lead having a variable stiffness lead body and most preferably adapted to be advanced into a selected coronary vein for delivering a pacing or defibrillation signal to a predetermined region of a patient's heart, such as the left ventricle is disclosed. A method of pacing and/or defibrillating a patient's heart using the lead is also described. The method of pacing or defibrillating the heart includes advancing the coronary vein lead through both the coronary sinus and into a selected coronary vein of a patient's heart, connecting the lead to an electrical pacing source and applying electrical stimulation to a particular chamber of the patient's heart via the implanted lead. The lead includes a variable stiffness lead body that enhances the ability of the lead to be retained in a coronary vein after the lead has been implanted therein.

Abstract: Methods and electronic tools for imaging a chest region of a patient and communicating with a heart stimulation device used by the patient are disclosed. The electronic tool may include a communications device for sending and/or receiving signals encoded with information to and from the heart stimulation device. The tool may also include an imaging device for radiating energy onto the chest of the patient and receiving energy as it is reflected from the chest region to produce an image signal. The tool may include a display screen for showing an image of the chest area and/or the information received from the heart stimulation device. The tool may also include a processor for formulating and/or analyzing information sent to and/or received from the heart stimulation device. One method of using the electronic tool includes analyzing the image signal and/or received information to provide instructions to the heart stimulation device.

Abstract: Disclosed is an improved system and method to selectively promote tissue in-growth on, or adjacent to, an implantable medical device. In one embodiment, at least one surface of the housing of a medical device is in contact with a first portion of a porous PTFE having a pore size adapted to prevent substantially all tissue in-growth. This first portion, or layer, of porous PTFE material is further in contact at predetermined locations with an additional porous PTFE layer having a pore size adapted to selectively promote tissue in-growth only at the predetermined locations. Each of the PTFE layers may be formed of porous PTFE tubing or tape. Alternatively, the two layers may comprise a single composite structure that has a more porous material exposed on a first surface, and a less porous, more dense, material on a second surface. Another embodiment of the invention involves forming the layers of PTFE into a removable member that is adjacent to at least one surface of the implantable medical device.

Abstract: The implantable medical device is provided with typically equal portions of both random access memory (RAM) and read only memory (ROM) and a virtual memory space is defined equal to the amount of memory in one of the memory devices. In a specific example, the RAM and ROM provide 256 K of memory each, with the virtual memory space also set to 256 K. A zone control register is provided which specifies, for each of a set of predetermined zones within the virtual memory space, whether memory access commands are to be routed to RAM or ROM. Control bits within the zone control register may be reset to permit portions of memory to be remapped from one memory device to the other. By providing RAM and ROM each typically equal in size to the virtual memory space, software for use in the device may be tested and debugged using RAM then transferred to ROM for use in production devices.

Abstract: A system and method of detecting and displaying parameter interactions. A medical device system has a medical device and a programming interface, wherein the medical device includes a plurality of features which can be programmed via the programming interface. A plurality of icons is defined, wherein the plurality of icons includes a first icon, a second icon and a third icon, wherein the first icon indicates correctness, wherein the second icon warns of a parameter interaction and wherein the third icon warns of impermissible parameter settings. Parameter interactions between feature parameters are identified and each of the parameter interactions is associated with one of the plurality of icons. A parameter value is accepted and examined to determine if it causes a parameter interaction. If the parameter value causes a parameter interaction, the icon associated with the parameter interaction is displayed.

Abstract: A device for the therapy of supraventricular and ventricular bradycardial and tachycardial disrhythmias and/or for influencing the heart pumping force, including: electrodes for electrical and/or magnetic stimulation of parasympathetic nerves which innervate the sinus node, the atria, the atrioventricular node or the ventricles; electrodes for electrical and/or magnetic stimulation of the atria and ventricles and/or for ventricular cardioversion/defibrillation; a device for producing electrical and/or magnetic stimulation pulses which are passed to the electrodes; and a device for detecting the rate at which the human atria and ventricles beat, wherein said device measures atrial and ventricular contractions.

Abstract: An apparatus and method for delivering electrical shock therapy in order to treat atrial tachyarrhythmias such as fibrillation is disclosed. In accordance with the method, atrial defibrillation shocks are delivered synchronously with an R wave if the current R-R interval meets one or more safety criteria so as to be considered shockable. A shockable R-R interval may be defined as one that exceeds the previous QT interval by a specified therapy margin. In one embodiment, the previous QT interval is estimated based upon the measured preceding R-R interval.

Abstract: An implantable endocardial lead includes an electrical conductor coupled at its distal end to an active fixation electrode movable between a retracted position and an extended position advanced beyond the lead end for penetration into the myocardial tissue. A resilient coupling mechanism maintains electrical continuity between the active fixation electrode and an electrically active housing throughout movement of the electrode. In one instance, a conductive coupling is slidably received on a conductive shaft and is fixed to the electrically active housing. A compression spring is received on the conductive shaft intermediate and engaged with the conductive coupling and with a conductive ring stop member projecting radially from the conductive shaft. In another instance, an annular track member integral with the electrically active housing has an annular recess surrounding the conductive shaft and a metallic coil spring is received in the annular recess and slidably engageable with the conductive shaft.

Abstract: A process for treating aberrant sensory afferents and motor efferents includes performing a singular sensory or motor function test, and identifying an area of dysfunction. A nerve root and pathway to the area of dysfunction, a structural or biochemical component of the dysfunction, vascular supply to the area of dysfunction, blood supply/lymphatic drainage for the area of dysfunction, and viscera associated with the area of dysfunction is then identified. These areas are stimulated using the therapeutic device until retesting no longer detects any dysfunction. Neurological inhibition is identified by performing two or more sensory or motor function tests simultaneously. The therapeutic device is used to stimulate the area of dysfunction, spine and head until the neurological inhibition is no longer detected.

Abstract: An implantable cardiac lead includes a connector having strain relief to protect the connector from damage during removal of the connector from an associated implantable cardiac stimulation device. The lead is elongated and has a distal end, a proximal end, an electrode, and a conductor coupled to the electrode and extending to the lead proximal end. A connector on the lead proximal end connects the conductor to a mating implantable device connector. The lead connector includes a body, a terminal carried by the body which is coupled to the conductor, an anchor longitudinally fixed on the lead and to the conductor distal to the terminal, and a strain relief member connected between the anchor and the terminal.

Abstract: A system and method of neuromodulation adjunct (add-on) therapy for atrial fibrillation, refractory hypertension, and inappropriate sinus tachycardia comprises an implantable lead-receiver and an external stimulator. Neuromodulation is performed using pulsed electrical stimulation. The external stimulator contains a power source, controlling circuitry, a primary coil, and predetermined programs. The primary coil of the external stimulator inductively transfers electrical signals to the implanted lead-receiver, which is also in electrical contact with a vagus nerve. The external stimulator emits electrical pulses to stimulate the vagus nerve according to a predetermined program. In a second mode of operation, an operator may manually override the predetermined sequence of stimulation. The external stimulator may also be equipped with a telecommunications module to control the predetermined programs remotely.

Abstract: A method for measuring near-field electrical activity at a location in a heart comprising introducing into the heart a catheter. The catheter comprises an elongated tubular body having a distal region and a circumferential recess along the length of the distal region, a first electrode mounted on the distal region in close proximity to the circumferential recess, and a second electrode mounted within the circumferential recess. The distal region is positioned at the location in the heart so that the first electrode is in direct contact with heart tissue and the second electrode is not in direct contact with heart tissue but is in contact with blood. A first signal is obtained with the first electrode, and a second signal is obtained with the second electrode. The first signal and the second signal are compared to obtain the near-field electrical activity at the location in the heart.

Abstract: A cartridge is provided for storing one or more electrode pads such as a defibrillator electrode pad. The cartridge includes a housing having a rigid portion, a storage space disposed within the housing, and a storage-space opening that allows one to remove/insert the electrode pad or pads from/into the storage space. Because it has a housing with a rigid portion, such a cartridge can better protect one or more electrode pads from handling damage. Furthermore, one can construct the cartridge such that it is attachable to a medical device such as an AED. This allows an operator to carry or store the medical device, cartridge, and one or more electrode pads as a single unit. In addition, one can construct the cartridge such that the one or more electrode pads can be pre-connected to the medical device. This can eliminate connecting the one or more electrode pads to the medical device during an emergency.

Abstract: A pacemaker or other implantable cardiac stimulation device is configured with both a rate hysteresis mode and a vasovagal syncope prevention mode. Within the rate hysteresis mode, the pacemaker detects when the intrinsic heart rate of the patient is below an escape rate, then paces the heart at a Base Rate until an intrinsic beat is detected. When programmed in the vasovagal syncope prevention mode, upon detecting the intrinsic rate falling below the Hysteresis Escape Rate, the pacemaker paces the heart at a Vasovagal Syncope Response Rate, which is considerably higher than the Base Rate. The pacemaker is preferably set to the syncope prevention mode for patients prone to recurrent vasovagal syncope. By pacing the heart at the higher Vasovagal Syncope Response Rate, the pacemaker thereby helps prevent a significant drop in blood pressure which might otherwise cause a loss of consciousness in the patient. System and method embodiments are described.